Can Liothyronine Tablets Be Broken?
Yes, liothyronine (T3) tablets can be broken or split, as this is a common and accepted practice in clinical management when dose adjustments are needed.
Practical Considerations for Tablet Splitting
- Liothyronine tablets are frequently split to achieve smaller dose increments, particularly when reducing doses by 12.5 mcg or making fine adjustments 1
- The short half-life of liothyronine (compared to levothyroxine) makes it suitable for twice-daily administration, which often involves splitting tablets to achieve appropriate dosing 2, 3
- When adjusting combination therapy with levothyroxine and liothyronine, starting doses of 2.5-7.5 mcg liothyronine once or twice daily are recommended, which typically requires tablet splitting 1
Clinical Context for Dose Adjustments
- Dose adjustments for liothyronine should be made in small increments of 12.5-25 mcg based on the patient's current dose to normalize thyroid function 4
- After any dose adjustment, TSH and free T4 levels should be rechecked in 6-8 weeks to evaluate response 4, 5
- Larger adjustments should be avoided as they may lead to overtreatment, especially in elderly patients or those with cardiac disease 4
Important Safety Considerations
- Breaking tablets allows for precise dose titration to avoid both under-treatment and over-treatment 4
- The occasional missing of a liothyronine tablet is more problematic than with levothyroxine due to its shorter half-life, making consistent dosing critical 2
- Excessive liothyronine consumption can cause severe thyrotoxicosis with cardiac complications, emphasizing the importance of accurate dosing 6
Monitoring After Dose Changes
- Check TSH and free T4 levels 6-8 weeks after any dose reduction or adjustment 5
- Monitor for symptoms of hypothyroidism including fatigue, cold intolerance, weight gain, hair loss, and constipation 5
- Avoid adjusting doses too frequently; wait 4-6 weeks between adjustments to reach steady state 5
- Once stabilized, continue monitoring thyroid function tests every 6-12 months 5